Accreditation
SINTA 2Nationally Accredited Journal
Vol. 10 No. 11 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Preterm Birth and Other Adverse Pregnancy Outcomes in Women With Chronic Kidney Disease: A Systematic Review with Exploratory Meta-Analyses in Lupus and Diabetic Nephropathy
Views: 49Downloads: 22Background: Chronic kidney disease complicates interpretation of pregnancy risk because exposure definitions, denominators, underlying diseases, and clinical practices vary. This review evaluates associations with preterm birth and other adverse pregnancy outcomes while preserving these distinctions.
Objective: To evaluate associations between pre-existing chronic kidney disease and preterm live birth and other adverse maternal and neonatal outcomes, and to determine which disease-specific estimates could be combined without conflating populations, outcome definitions, or crude and adjusted effects.
Methods: PubMed and Europe PMC were searched with supplementary renal disease and microalbuminuria searches. Comparative observational studies were assessed using a prespecified protocol registered as CRD420261503668. Extraction distinguished established CKD, reduced kidney function, and disease-matched comparisons. Exploratory sensitivity analyses used crude risk ratios, restricted maximum likelihood, and modified Hartung–Knapp intervals.
Results: Thirty-four reports were mapped; eight contributed to three disease-matched crude analyses. The prespecified adjusted primary CKD estimate could not be pooled. Pooled risk ratios were 1.12 (95% confidence interval 0.13–9.35) for lupus-nephritis preterm birth, 2.79 (0.84–9.25) for lupus-nephritis preeclampsia, and 1.35 (1.21–1.51) for diabetic-nephropathy cesarean delivery. Adding a quiescent-nephritis cohort yielded a preterm-birth ratio of 1.24 (0.39–3.97). One cohort contributed 92.1% of the cesarean-analysis weight. Certainty was very low.
Conclusion: Diabetic nephropathy was associated with higher crude cesarean-delivery risk, whereas lupus-nephritis estimates remained highly imprecise. Confounding, repeated pregnancies, and restricted evidence availability limit clinical inference.
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Neglected Open-Globe Injury and Limb Amputation Following a Blast Explosion in a Pediatric Polytrauma Patient: An Observational Analytic Case Study on Delayed Ophthalmic Intervention, Ocular Trauma Score Dynamics, and Health System Barriers in Remote Eastern Indonesia
Views: 32Downloads: 22Background: Blast-related ocular trauma in children in archipelagic developing regions is a devastating, multimechanistic emergency, often complicated by systemic polytrauma prioritization and geographical referral barriers.
Objective: To characterize the clinical trajectory, Ocular Trauma Score dynamics, and health-system barriers of a neglected pediatric open-globe blast injury with concomitant traumatic hand amputation in remote eastern Indonesia.
Methods: A 13-year-old boy presented 5 days after a homemade fish-bomb explosion. Evaluation used Birmingham Eye Trauma Terminology (BETT) classification, longitudinal biomicroscopy, acoustic B-scan ultrasonography, quantitative Ocular Trauma Score (OTS) and modified Pediatric OTS, and multi-level structural barrier assessment.
Results: At presentation (Day 5), right eye (OD) visual acuity was light perception with intraocular pressure of 7 mmHg, full-thickness superior eyelid margin laceration, total dark hyphema (Grade IV), and traumatic corneal scars, while the left eye (OS) maintained 20/20 vision with multiple corneal foreign bodies. Acoustic B-scan OD revealed complete funnel-shaped retinal detachment tethered to the optic disc and dense vitreous hemorrhage. OD calculated an OTS raw score of 12 (Category 1, 74% no-light-perception probability). Following surgical delays driven by maritime transit and BPJS insurance administrative bottlenecks, 1-week follow-up (Day 12) revealed fulminant corneal keratolysis with diffuse stromal melting, chemosis, and cicatricial eyelid notch, whereas OS achieved complete corneal re-epithelialization.
Conclusion: Neglected pediatric blast ocular trauma leads to accelerated enzymatic keratolysis and irreversible functional amaurosis when systemic polytrauma prioritizes limb salvage over sight. Integrating mandatory ophthalmic triage into rural disaster protocols is critical.
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Ocular Tuberculosis in Advanced Proliferative Diabetic Retinopathy: A Diagnostic and Therapeutic Dilemma in A Vitrectomized Eye
Views: 26Downloads: 6Background: Ocular tuberculosis (OTB) is a paucibacillary extrapulmonary infection, hard to recognize in an eye compromised by proliferative diabetic retinopathy (PDR) and vitreoretinal surgery, where postoperative inflammation, tamponade artifacts, hemorrhage and diabetic microangiopathy mimic infectious uveitis.
Objective: To characterize the diagnosis, molecular confirmation, and longitudinal outcomes of occult ocular tuberculosis in a vitrectomized eye with end-stage proliferative diabetic retinopathy.
Methods: A 50-year-old man with type 2 diabetes and pulmonary tuberculosis presented with acute inflammation (OD) 5 days after pars plana vitrectomy. He was followed over six milestones (T0–T5, 16 weeks) with SD-OCT and vitreous nested RT-PCR (IS6110/MPB64); outcomes were best-corrected acuity (LogMAR), intraocular pressure and central macular thickness (CMT).
Results: At T0 (OD 1/300, LogMAR 2.48) with ciliary flush and gas endotamponade, vitreous RT-PCR was positive for M. tuberculosis DNA (IS6110/MPB64), establishing intraocular tuberculosis masked by surgical inflammation. Quadruple antituberculous therapy (RHZE) with corticosteroids improved vision to 6/30 (LogMAR 0.70) by week 3 and 6/21 (LogMAR 0.54) by week 6. At week 7, SD-OCT unmasked diabetic cystoid macular edema (CMT 365 µm) that responded to sub-Tenon triamcinolone (CMT 340 µm), with final acuity 6/9.5 corrected (LogMAR 0.20) at week 16. The contralateral eye (OS) developed neovascular glaucoma (IOP 51.0–63.0 mmHg) and no light perception, requiring silicone oil evacuation.
Conclusion: Ocular tuberculosis must be suspected in atypical intraocular inflammation in vitrectomized eyes, especially with tuberculosis or diabetes. Vitreous PCR is decisive when signs overlap with surgical trauma and diabetic microangiopathy, and prompt antituberculous plus corticosteroid therapy can achieve visual salvage.
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Prenatal Identification, Transitional Hemodynamic Remodeling, and Multidisciplinary Management of Ebstein's Anomaly with Coexistent Urogenital Malformations: An Observational Analytic Case Study
Views: 13Downloads: 8Background: Ebstein’s anomaly is an uncommon congenital heart defect with failed tricuspid delamination, right-ventricular atrialization, and severe regurgitation. Prenatal detection is difficult on routine obstetric ultrasonography, and perinatal hemodynamic transition carries substantial mortality.
Objective: To document the prenatal identification, transitional neonatal hemodynamic remodeling, and multidisciplinary management of Ebstein’s anomaly with coexistent urogenital malformation.
Methods: A 28-year-old multigravida referred at 34–36 weeks with a suspected cardiac anomaly was followed through multidisciplinary re-evaluation, term cesarean delivery, neonatal intensive care, and 3-month follow-up, with serial hemodynamic profiling and risk stratification.
Results: Initial referral ultrasound suspected double outlet right ventricle, which was revised to Ebstein’s anomaly (Carpentier Type B) with dilated pulmonary trunk and coexistent bilateral testicular hydrocele and hypospadias upon joint fetomaternal-pediatric cardiology assessment. Delivery at 38–39 weeks yielded a male neonate (3,050 g, Apgar 5/7, SpO2 85%). Postnatal echocardiography confirmed Ebstein’s anomaly with moderate-to-severe tricuspid regurgitation (peak pressure gradient 78 mmHg), a 3–4 mm atrial septal defect with right-to-left shunting, and a 3 mm patent ductus arteriosus with left-to-right shunting. Conservative medical stabilization utilizing non-invasive continuous positive airway pressure, oral captopril, and furosemide averted emergency neonatal cardiac surgery. At 3 months, serial echocardiography revealed spontaneous ductal closure, reduction of tricuspid pressure gradient to 21 mmHg (Δ% = -73.1%), shunt reversal to left-to-right, and complete hydrocele resolution.
Conclusion: Late third-trimester diagnostic conversion highlights the need for structured fetal echocardiography beyond four-chamber views. Favorable outcomes in severe Ebstein’s anomaly are achievable through coordinated multidisciplinary care, where falling pulmonary vascular resistance drives non-operative hemodynamic remodeling.
